David, if you plug in and list so-called healthspan treatments--you will not see one that is scientifically proven at scale and holds efficacy. Not ONE! What you see is rodent testing trials or temporary improvements not lifechangers.
I agree with the premise of what is outlined. Reality is like Alzheimer’s we rarely have verifiable objective evidenced based parameters to follow to stand on sound scientific grounds. Training more doctors sounds great but investing in research or better conducting research with doctors trained within your institution would be priceless
Beautifully said. I love the “clinical architecture” framing, because that’s exactly what patients (and responsible clinicians) are ultimately asking for: repeatable standards, transparent reasoning, and accountability, not just charismatic protocols.
The “safety rails” point is especially important. In day-to-day practice, the trust gap rarely comes from a lack of enthusiasm for longevity; it comes from variability: different labs, different thresholds, different claims, and no shared language for what’s evidence-based vs. exploratory. Physician-led governance and standardized methods don’t slow the field down, but they’re what allow it to scale safely and earn mainstream legitimacy.
The emphasis on evidence generation from real-world practice is the move. If we can couple standards + outcomes + peer learning, longevity medicine stops being “adjacent to medicine” and becomes a durable clinical discipline.
Dr. Luu, this is the precise structural shift the field has been waiting for. You are effectively distinguishing between "Wellness Theater" (entertainment) and "Clinical Architecture" (medicine).
The fragmentation you describe is the hallmark of an immature system. By establishing governance and standardized protocols, you aren't just legitimizing the field; you are creating the necessary safety rails for it to scale. We cannot build a skyscraper on a foundation of biohacks. This manifesto is the blueprint for the real work.
A great manifesto to carry us into 2026.
David, if you plug in and list so-called healthspan treatments--you will not see one that is scientifically proven at scale and holds efficacy. Not ONE! What you see is rodent testing trials or temporary improvements not lifechangers.
I agree with the premise of what is outlined. Reality is like Alzheimer’s we rarely have verifiable objective evidenced based parameters to follow to stand on sound scientific grounds. Training more doctors sounds great but investing in research or better conducting research with doctors trained within your institution would be priceless
Beautifully said. I love the “clinical architecture” framing, because that’s exactly what patients (and responsible clinicians) are ultimately asking for: repeatable standards, transparent reasoning, and accountability, not just charismatic protocols.
The “safety rails” point is especially important. In day-to-day practice, the trust gap rarely comes from a lack of enthusiasm for longevity; it comes from variability: different labs, different thresholds, different claims, and no shared language for what’s evidence-based vs. exploratory. Physician-led governance and standardized methods don’t slow the field down, but they’re what allow it to scale safely and earn mainstream legitimacy.
The emphasis on evidence generation from real-world practice is the move. If we can couple standards + outcomes + peer learning, longevity medicine stops being “adjacent to medicine” and becomes a durable clinical discipline.
Dr. Luu, this is the precise structural shift the field has been waiting for. You are effectively distinguishing between "Wellness Theater" (entertainment) and "Clinical Architecture" (medicine).
The fragmentation you describe is the hallmark of an immature system. By establishing governance and standardized protocols, you aren't just legitimizing the field; you are creating the necessary safety rails for it to scale. We cannot build a skyscraper on a foundation of biohacks. This manifesto is the blueprint for the real work.
Dr Tom Kane
Very well said. Thrilled to be a part of the movement!